Mr. Mike's Sunday In-Home Lesson Form
Sign up for in-home lessons with Mr. Mike between June 3-August 30.
Parent/Caregiver Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Student 1 Lesson Reservation
Select the weeks Student 1 will attend lessons. Select at least six lessons to hold your spot for the next school year.
Student 1 Name
*
First Name
Last Name
Student 1 - Usual Sunday Lesson Time:
*
Hour Minutes
PM
AM/PM Option
Student 1 Lesson Length
*
I want to keep the same lesson length (i.e. 30 minutes)
I want to increase the lesson length (i.e. 30 to 45 minutes)
I want to hear my teacher's opinion about increasing the lesson length
Student 1 - Sunday In-Home Lesson Times
*
Book my usual time.
I'd like a different time or day this week.
No lesson this week.
June 8
June 15
June 22
June 29
July 13
July 20
July 27
August 3
August 10
Student 2 Lesson Reservation (if applicable)
Select the weeks Student 2 will attend summer lessons. Select at least six lessons to hold your spot for the next school year.
Student 2 - Usual Sunday Lesson Time:
Hour Minutes
PM
AM/PM Option
Student 2 Lesson Length
I want to keep the same lesson length (i.e. 30 minutes)
I want to increase the lesson length (i.e. 30 to 45 minutes)
I want to hear my teacher's opinion about increasing the lesson length
Student 2 - Sunday In-Home Lesson Times
Book my usual time.
I'd like a different time or day this week.
No lesson this week.
June 8
June 15
June 22
June 29
July 13
July 20
July 27
August 3
August 10
Tuition
Tuition rates may be found here: https://mattixmusic.com/summer-in-home-lessons/
Tuition
*
Charge my card on file for the number of lessons I indicated above.
Send me an invoice; I will pay in full by May 1st, 2025.
Signature
*
Submit
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